The Importance of Screening

The Importance of Screening

Developmental Screening

With as many as 1 in 4 children at risk for developmental delay, universal early childhood screening provides an opportunity to identify delays early and intervene during the most critical period of development.1,2 Considering that standard developmental screenings may not reveal indications of autism spectrum disorder (ASD) nor social-emotional concerns, it is important to conduct ASD-specific and social-emotional screenings as well.3 However, approximately 40% of pediatricians do not consistently complete recommended developmental screenings.4

The AAP recommends conducting developmental surveillance at every health supervision visit and conducting developmental screening using formal, validated tools at 9, 18, and 30 months or whenever surveillance reveals a concern.5 In addition, the AAP recommends that all children be screened for autism spectrum disorder at 18 and 24 months.6 Furthermore, the AAP recommends that children are screened with formal, validated tools at regular intervals for behavioral and emotional problems beginning in the first year of life.

Click here to view tools to assess early childhood development and here for resources to implement a screening program in your practice.

Maternal Depression​

Approximately 10 percent of women suffer from depression during the postpartum period, but it is estimated that fewer than half of cases are recognized.8 Children of mothers with depression are more likely to have cognitive, neurological, and motor delays and to have ongoing behavioral challenges.9

Screening for perinatal depression increases opportunities for intervention, thereby improving outcomes for both mothers and their children.10 Pediatric health care providers are well-positioned to screen women for postpartum depression due to their frequent contact with families during t​​he child’s first year of life.

Social Determinants of Health

In the absence of protective relationships, exposure to toxic stress such as poverty and adverse childhood experiences can disrupt the architecture of a child’s developing brain, leading to long-term behavioral and health problems13. In addition, factors such as food insecurity, unsafe housing, and domestic or community violence pose a direct threat to the health of children.14

Nearly half of all children live in poverty or near poverty, and about a quarter of children have been impacted by at least one adverse childhood experience.15 As part of their role in supporting healthy development and providing anticipatory guidance, pediatric health care providers can identify toxic stress and refer families to services, as well as build protective factors in children and families to ameliorate the effects of these exposures.

The AAP
recommends using a
written screener or verbally asking family members questions about basic needs such as food, housing, and heat during patient encounters.16

Click
here to view tools to assess these factors and
here for additional resources to implement a screening program in your practice.

Protective Factors

Protective factors, such as family strengths and
resiliency, have an important role in the screening process and family-centered care. In the event that a child is exposed to a traumatic experience, these protective factors can mitigate its impact on development. Through their interactions with the family, pediatric health care professionals have a unique opportunity to encourage building of protective factors, whether it's through supporting the child's capacity to learn through a program such as Reach out and Read, or engaging in an ongoing dialogue with parents about their child's development so that they understand how they can encourage positive growth.​​